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'Aggressive' ResMed
#1
'Aggressive' ResMed
I was reading an article about the differences between the ResMed Airsense and the Respironics Dreamstation.  It kept saying, 'ResMed more aggressive.'  What is meant by this I am wondering?
A few days ago I changed from the Dreamstation to the ResMed for Her.  I wish I hadn't!  On the same settings, this machine, I  swear, is trying to blast a hole in the back of my head, but failing to do so it is blowing my mouth open even though I am wearing a collar to keep it closed.  This feels pretty aggressive to me, but is that what it means?  I  am going to try to get my Dreamstation back.
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#2
RE: 'Aggressive' ResMed
Resmed responds more dynamically to reduce apnea events. This is generally good.

The For Her has several options to soften the response though. First of all, there is the For Her mode, which responds sooner but doesn’t raise the pressure as much. There is also a Response option (with options for Regular and Soft response).

Also, Flex is not directly comparable to EPR. If you were using Flex 3, you might find EPR 2 more comfortable.

However, your profile info in the sidebar says your CPAP pressure is 20. Is that really your prescription pressure, or is the machine still set at the default range of 4 to 20? If so, I suspect that is why you are so uncomfortable.

FWIW, I recently switched from a Dreamstation to the same machine you have. Even on the more dynamic regular settings (not For Her or Soft Response), I switched because I found the Resmed to be more comfortable, allowing me to sleep better.

I’m not an expert at advising you on what your settings should be, but I’m pretty sure the trouble you are having is because your settings are not optimal.

You may also want to verify your hose and mask settings. Those can also cause a big whoosh of air if they don’t match what you are really using.
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#3
RE: 'Aggressive' ResMed
One of the things ResMed does is increase pressure in response to the presence of flow limitations. We need to see your charts, and limit your max pressure for now. Need to know your EPR too. Once we see that you will find that it is quite comfortable.
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#4
RE: 'Aggressive' ResMed
Guiniviere,
Were you using OSCAR software with your DreamStation?  Do you already have OSCAR set up?  If not, please download it before making a decision to switch machines again.  We can look at a night or two of your data, and will be better able to advise.

The links in my signature line below will guide you.  

I do agree that you pressure setting of 4-20 is not optimal.  Your minimum probably needs to be higher and your maximum lower.  But let us see your data first.  We can help.
OpalRose
Apnea Board Administrator
www.apneaboard.com

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#5
RE: 'Aggressive' ResMed
I just inferred that her pressure is still at the 4 to 20 default based on the “20”.
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#6
RE: 'Aggressive' ResMed
(10-13-2019, 05:54 PM)ragtopcircus Wrote: Resmed responds more dynamically to reduce apnea events. This is generally good.

The For Her has several options to soften the response though. First of all, there is the For Her mode, which responds sooner but doesn’t raise the pressure as much. There is also a Response option (with options for Regular and Soft response).

Also, Flex is not directly comparable to EPR. If you were using Flex 3, you might find EPR 2 more comfortable.

However, your profile info in the sidebar says your CPAP pressure is 20. Is that really your prescription pressure, or is the machine still set at the default range of 4 to 20? If so, I suspect that is why you are so uncomfortable.

FWIW, I recently switched from a Dreamstation to the same machine you have. Even on the more dynamic regular settings (not For Her or Soft Response), I switched because I found the Resmed to be more comfortable, allowing me to sleep better.

I’m not an expert at advising you on what your settings should be, but I’m pretty sure the trouble you are having is because your settings are not optimal.

You may also want to verify your hose and mask settings. Those can also cause a big whoosh of air if they don’t match what you are really using.

Thank you for your message.  The machine is set for Her, soft Response, and EPR is on 2;  also is only set at the default pressures. I do not have a  prescription setting; I was given to understand that with an auto machine it was not needed as the machine would sort it out. I don't know how that 20 got in there (and I can't seem to find a way back to edit those settings.) I am seeing the DME people tomorrow so I will discuss this prescription setting with them. 
It is interesting that you also have just changed from the Dreamstation to the ResMed fo Her.  If you don't mind my asking, what was your reason?  For myself, I simply thought that if it was designed specifically for women then it ought to be better.  I 'm not convinced and I really dislike the childish smiles and the scoring in myAir.
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#7
RE: 'Aggressive' ResMed
MyAir is designed to encourage compliance.  The best program to use is OSCAR.  It is what we base most of our suggestions on.
An AutoSet works best when optimized, but you can use a wide range to see what those values should be.
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#8
RE: 'Aggressive' ResMed
(10-13-2019, 06:03 PM)bonjour Wrote: One of the things ResMed does is increase pressure in response to the presence of flow limitations.  We need to see your charts, and limit your max pressure for now.  Need to know your EPR too.  Once we see that you will find that it is quite comfortable.

Thank you bonjour for your response.  Unfortunately I have not yet got into OSCAR so cannot show you any charts.    I do have a month's worth of results from DreamMapper for the Dreamstation with the 95% pressures if that is any help.  EPR on the ResMed is set at 2.  Your preference is for the ResMed rather than the Respironics?  Would be interested to know your reasons...
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#9
RE: 'Aggressive' ResMed
(10-13-2019, 06:50 PM)OpalRose Wrote: Guiniviere,
Were you using OSCAR software with your DreamStation?  Do you already have OSCAR set up?  If not, please download it before making a decision to switch machines again.  We can look at a night or two of your data, and will be better able to advise.

The links in my signature line below will guide you.  

I do agree that you pressure setting of 4-20 is not optimal.  Your minimum probably needs to be higher and your maximum lower.  But let us see your data first.  We can help.
Thank you for your response and your kind offer of help to this new member of the sleep apnea world who is feeling a bit overwhelmed with it all.....

As I just said to bonjour, I have not yet got into OSCAR, and honestly, if I were to download it this very minute, I think it would take me a good few days to become familiar enough with it to be able to post any data; and really, apart from it trying to blow my head off, there are other reasons I would rather have the Dreamstation back:  for one thing, unlike DreamMapper, I cannot see separate readings for central and obstructive apneas, and the hypopneas in MyAir.  I do not like the childish smilies and scoreboard.  I find the hose unwieldy compared to the Dreamstation hose.  The screen is dim and writing on it so small I practically need a Hubble telescope to read it!

I am sure you are right about the pressure settings needing to be adjusted, and I shall discuss the matter with the DME people tomorrow,  but they were the same on the Dreamstation and that did not cause the hurricane in my head like  the ResMed is.
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#10
RE: 'Aggressive' ResMed
ResMed
1. Responds faster to events to prevent future events.  
2. PRs slower response requires a Higher Min pressure and thus a higher average pressure 
3. making you more susceptible to leaks from higher pressures and 
4. more susceptible to Aerophagia.
5. PR algorithms tend to predict when your breathing should change from inhale to exhale and vice versa frequently missing the intended changeove and causing discomfort.
6. ResMeds EPR can be used as a mini BiLeven for treating Hypopneas, Flow Limitations, RERAs, and Snoring.
7. ResMed displays a Flow Limit Chart indicating severity instead of just an event for the most severe.
8. ResMed displays a Snores Chart instead of just an event for the most severe.
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